OBJECTIVE This paper aimed to discuss the scope of operation and clinical effects for locally advanced cervical cancer (LACC) after concurrent chemoradiotherapy (CCRT). METHODS We retrospectively reviewed the records of 444 patients with stages IB2-IIB cervical cancer who were divided into two groups whether or not they received CCRT before radical operation in our institute from January 2013 to December 2016. Patients' characteristics, treatments, and outcomes were analyzed. RESULTS The total efficiency (CR + PR) of the CCRT + operation group was 96.2%. Specifically, the CR rate was 9.1%, and the PR rate was 87.1%. The positive rates of cervical deep interstitial infiltration, lymphatic metastasis, and lymphangial infiltration of the operation group were significantly higher than those of the CCRT + operation group (P < 0.05). A total of 24 and 162 patients in the CCRT + operation group and the operation group, respectively, received adjuvant therapy (P < 0.05). The incidence rate of edema of the lower extremity, radiation enteritis, and radiocystitis after postoperative adjuvant radiotherapy in the operation group was significantly higher than that of the CCRT + operation group (P < 0.05). The 5-year survival rates and 5-year progression-free survival (PFS) rates of the CCRT + operation and operation groups were 79.3% versus 64.0% and 68.9% versus 45.2%, respectively (P < 0.05). CONCLUSIONS Comprehensive treatment that combines CCRT and radical operation to LACC achieves satisfying clinical effects without increasing the occurrence rate of intraoperative and postoperative complications. Moreover, such treatment can improve the 5-year PFS rate and OS rate.

中文翻译：

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同步放化疗后局部晚期宫颈癌的手术。

目的探讨并发放化疗后局部晚期宫颈癌（LACC）的手术范围和临床疗效。方法回顾性分析我院2013年1月至2016年12月行根治性手术前是否接受CCRT的444例IB2-IIB期宫颈癌患者的临床资料。患者的特点，治疗方法及疗效分析。结果CCRT +手术组的总效率（CR + PR）为96.2％。具体而言，CR率为9.1％，PR率为87.1％。手术组宫颈深层间质浸润，淋巴结转移和淋巴管浸润的阳性率明显高于CCRT +手术组（P <0.05）。CCRT +手术组和手术组分别有24例和162例患者接受了辅助治疗（P <0.05）。术后辅助放疗后下肢水肿，放射性肠炎和放射性膀胱炎的发生率明显高于CCRT +手术组（P <0.05）。CCRT +手术组和手术组的5年生存率和5年无进展生存率分别为79.3％对64.0％和68.9％对45.2％（P <0.05）。结论将CCRT和根治性手术相结合的LACC的综合治疗在不增加术中和术后并发症发生率的情况下取得了令人满意的临床效果。而且，这种治疗可以提高5年PFS率和OS率。